Lorain, Elyria health officials continue to discuss merger

ELYRIA — The health departments of Lorain and Elyria already are sharing some resources, but more work is needed if the two agencies are to join.
On Monday about 19 local government officials and Lorain and Elyria health workers gathered at Lorain County Community College for a three-hour retreat to continue discussion about consolidating their services.
The Lorain and Elyria health department boards both have approved resolutions declaring their intent to study how they might work together.
However, the health departments have not yet scored any money to pay for a feasibility study that would outline how the two might join, said Shara L. Davis, dean of Research, Institutional Effectiveness and Public Services at LCCC.
Even so, the merger talks continue and could move forward if the departments apply for a state Local Government Innovation Fund grant that pays for ways local governments can better deliver their services, Davis said.
The group heard from John Hoornbeek, director of the center for Public Policy and Health at Kent State University, who explained potential benefits and challenges when health departments merge.
“There’s already been what I would call commendable efforts to share staff,” Hoornbeek said.
Lorain and Elyra already share the time of Health Commissioner Kathy Boylan, Medical Director Dr. Doug McDonald, who work through the Elyria agency, and Director of Nursing Kathy Loughrie, who works out of the Lorain department.
Consolidation tends to increase efficiencies of services for small jurisdictions with fewer than 100,000 people and tends to save money for the cities involved, Hoornbeek said. There also is some preliminary evidence that consolidation has positive effects relating to services, he said.
It is inconclusive, but there are some advantages to being large and providing services, Hoornbeek said. When combining two agencies, it forces staff to rethink the traditional work patterns they use in providing services, he said.
However, consolidation also can be disruptive with transition challenges for operations and may result in short-term reductions in external revenues, Hoornbeek said.
He added that consolidating organizations does not mean there won’t be changes, and if Lorain and Elyria move in this direction there are going to be some of those challenges to deal with.
It appeared Lorain and Elyria would be the first two cities in Ohio to join, said Don Killinger, who is president pro tem of the Lorain City health board.
Hoornbeek confirmed they would be the first two noncontiguous cities in Ohio to join, but the officials would have to work out logistics. Lorain also contracts to provide nursing and environmental services for Avon Lake.
The process also does not happen overnight, he said, with agreement needed by the participating health departments and their boards, along with mayors and city councils. The governance structures also can be complex, he added.
“It takes time,” Hoornbeek said.
Any consolidation also will require both the cities to be financially healthy, Elyria Mayor Holly Brinda said.
She noted between Lorain and Elyria, her city has the smaller population but makes a larger financial contribution to its city health department.
Elyria also has about 15 full-time and nine part-time workers, while Lorain has about 10, Boylan said. Lorain’s health workers also are not unionized, but Elyria’s are, Lorain health board member Edward McNamara said.
Hoornbeek agreed and said her points “are fundamentally important” in examining whether to join. Both departments are adding to the financial burdens of their respective cities at time when the cities don’t have money to spare, he said.
“The blunt truth is, consolidation itself does not guarantee sustainability,” Hoornbeek said.
Even the Local Government Innovation Fund grants top out at $50,000 and the health departments must find some matching funds — likely $25,000 to $40,000 — to apply for it, he said. They also need at least two committed local government partners, so Lorain and Elyria officials must decide if a merger is in their best interests, Hoornbeek said.
“There’s no way around some form of a local match here,” he said.
The KSU Center for Public Policy and Health will assist the departments in seeking the grant, Hoornbeek said.
Other participants included: Lorain Mayor Chase Ritenauer; Lorain health board members Mary Santiago and Natalie Rodriquez; Lorain health department workers Fleming Mosely and Ann Boehnlein; Elyria health board members Bob Schloss, Regina Shockley, Suzin Stefanelli and Brian Lander; Elyria health department workers Tammy Dietsche, Deborah Conner and Dave Oakes; and Brian Frederick, president and chief executive officer of the Community Foundation of Lorain County.
The meeting had a second component as the health department workers also discussed strengths and new initiatives that will fit with Lorain County’s Community Health Improvement Plan. The plan is a comprehensive guide that other health and public agencies will work with, including the Lorain County General Health District, the county Mental Health Board, Alcohol and Drug Addiction Services, Mercy Regional Medical Center, EMH Elyria Medical Center and Lorain County Metro Parks.
The strengths of the departments include experienced work forces, especially with public health nurses and education. As for new initiatives, they also suggested better communication to inform the public about the departments; expanding visits to parents of newborns; and working with schools, especially on teen pregnancy programs.